Nursing Elites

1. When dismissing a 5-year-old boy from the pediatrics unit, what type of seat belt restraint should the child wear as the parents drive the car to the front door of the hospital?

• A. A 5-point restraint in the back seat, facing backward
• B. A booster seat with a lap and shoulder belt in the back seat
• C. A lap belt in the back seat
• D. A lap and shoulder belt in the front seat

Correct answer: B

Rationale: A 5-year-old child riding in a car should use a restraint system for safety. The Centers for Disease Control and Prevention recommend that children under 13 years should not ride in the front seat of a car due to safety concerns. For a 5-year-old child, a booster seat with a lap and shoulder belt in the back seat is the most appropriate choice. This setup ensures proper protection and restraint for the child's size and age. Choice A is incorrect because a 5-point restraint system facing backward is not suitable for a 5-year-old child in a car. Choice C is incorrect as a lap belt alone does not provide adequate protection for a child of this age. Choice D is incorrect as children should not be seated in the front seat, especially at this young age.

2. When are manual hematocrits done?

• A. to monitor anemia
• B. by using a microhematocrit tube.
• C. to measure the percentage of plasma to cells.
• D. All of the above.

Correct answer: D

Rationale: Manual hematocrits are performed to monitor anemia, which involves measuring the percentage of red blood cells in the blood. The process involves collecting blood in a microhematocrit tube, then centrifuging it to separate the plasma from the cells. By measuring the ratio of plasma to cells, healthcare providers can assess the patient's hematocrit level. Therefore, all the provided options are correct as they collectively describe the purpose and procedure of manual hematocrits.

3. When caring for a patient with latex allergy, the healthcare provider creates a latex-safe environment by doing which of the following?

• A. Carefully cleaning the wall-mounted blood pressure device before using it.
• B. Donning latex gloves outside the room to limit powder dispersal.
• C. Using a latex-free pharmacy protocol.
• D. Placing the patient in a semi-private room.

Correct answer: C

Rationale: Creating a latex-safe environment for a patient with latex allergy is crucial to prevent allergic reactions. Using a latex-free pharmacy protocol is essential as it ensures that medications and supplies provided to the patient are free of latex components. Cleaning a wall-mounted blood pressure device may not be sufficient as the device itself may contain latex parts that can trigger an allergic reaction. Donning latex gloves, even outside the room, is not recommended as powder dispersal can cause issues; only non-latex gloves should be used in a latex-safe environment. Placing the patient in a semi-private room does not directly address the need to eliminate latex exposure from medical supplies and equipment, which is better achieved through a latex-free pharmacy protocol.

4. An older adult patient brought to the emergency department by a family member is wandering outside, saying, "I can't find my way home."? The patient is confused and unable to answer questions. What is the nurse's best action?

• A. Document the patient's mental status and obtain other assessment data from the family member.
• B. Record the patient's answers to questions on the nursing assessment form.
• C. Ask an advanced practice nurse to perform the assessment interview.
• D. Call for a mental health advocate to maintain the patient's rights.

Correct answer: A

Rationale: In this scenario, the patient is confused and unable to answer questions. When the patient is unable to provide information, it is important to use secondary sources such as family members. The nurse's best action is to document the patient's mental status and obtain additional assessment data from the family member. This approach will help gather relevant information about the patient's condition. Asking an advanced practice nurse to perform the assessment interview is not necessary as it is within the staff nurse's scope of practice. Calling for a mental health advocate is also unnecessary at this point as the priority is to assess the patient's condition and gather information from the family member.

5. Which of the following is an example of a positive effect of exercise on a client?

• A. Decreased basal metabolic rate
• B. Decreased venous return
• C. Decreased work of breathing
• D. Decreased gastric motility

Correct answer: C

Rationale: The correct answer is 'Decreased work of breathing.' Exercise has numerous positive effects on clients, such as increasing metabolic rate, improving gastric motility, and enhancing venous return. When a client exercises regularly, their work of breathing decreases, meaning that everyday activities require less exertion. This is beneficial as it indicates improved cardiovascular and respiratory efficiency. Choices A, B, and D are incorrect because a decreased basal metabolic rate, decreased venous return, and decreased gastric motility are not typically considered positive effects of exercise. Instead, an increased basal metabolic rate, improved venous return, and optimal gastric motility are desired outcomes associated with physical activity.

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